Hospital management reform policy： it is more convenient for doctors not to participate in income-generating medical treatment
BEIJING, Beijing, July 27 (Wu Tao) Recently, the General Office of the State Council issued "Guiding Opinions on Establishing Modern Hospital Management System" (hereinafter referred to as "Guiding Opinions"), which made a series of arrangements for establishing modern hospitals. What will the modern hospital be built into? Is it more convenient for people to see a doctor? What changes have been made to the salary of medical staff? Zhongxin. com has combed and summarized this.
What will a modern hospital look like?
— — Adhere to public welfare and control the scale of special needs services in hospitals
The Guiding Opinions pointed out that modern hospitals first adhere to the public welfare of public hospitals, adhere to the people’s health as the center, and put people’s health in a strategic position of giving priority to development. Modern hospitals adhere to the separation of government affairs and management, reasonably define the government’s supervisory responsibilities, and give public hospitals the right to operate and manage independently.
The reporter observed that the Guiding Opinions put forward some particularly detailed requirements for modern hospitals. For example, it is necessary to strictly control the bed size, construction standards and large-scale medical equipment in public hospitals, prohibit debt construction and luxury decoration, and gradually compress beds that exceed the scale standards. Control the scale of special services in public hospitals, and the proportion of special services provided shall not exceed 10%.
The opinions in the Guidance also suggest that an accountability mechanism should be established for acts such as arbitrary charges and bad practices that have a major social impact, acts that have caused major medical accidents and major safety accidents, serious cases of violation of laws and discipline, and serious violations of the construction of professional ethics.
It is worth noting that modern hospitals put forward a series of requirements for the position of dean. The dean should be fully responsible for medical treatment, teaching, scientific research and administrative management. The president’s office meeting is the administrative and business decision-making body of public hospitals, which makes decisions on discussion and research matters. At the same time, the annual and term target responsibility of the president is assessed, which is linked to the president’s salary, appointment and dismissal, rewards and punishments.
Wu Ming, a professor at peking university health science center College of Public Health, believes that the Guiding Opinions not only gives public hospitals the right to operate and manage independently, but also promotes the reform of medical insurance payment method, cancels drug addition, adjusts the price of medical services, reduces the price of medical consumables, and the "two-vote system", and establishes an effective competition mechanism in the medical service market to form an effective constraint on public hospitals, so as to ensure that the dean has the right not to be willful.
It is more convenient for patients to see a doctor.
— — Strengthen the emergency power and smooth the green channel
What impact does the establishment of modern hospitals have on patients? First of all, the doctor-patient relationship that everyone is concerned about is mentioned in the Guiding Opinions, for example, promoting the construction of the "three mediations and one insurance" mechanism that organically combines hospital mediation, people’s mediation, judicial mediation and medical risk sharing mechanism, properly resolving medical disputes and building a harmonious doctor-patient relationship.
The Guiding Opinions also pointed out that patients’ satisfaction is an aspect of the assessment of medical staff, and the assessment of medical staff is directly related to their salary level and even job appointment and dismissal. City doctors have served at the grassroots or counterpart medical institutions for not less than 1 year before being promoted to the title of attending physician or deputy chief physician.
In addition, the "Guiding Opinions" proposes to carry out information-based convenience services such as medical guidance, settlement between clinics, push of inspection results, and settlement of medical treatment in different places. Develop high-quality nursing services and strengthen the services of social workers and volunteers. All these provide better services for people to see a doctor.
In addition, tertiary public hospitals should all participate in the construction of medical complexes and play a leading role. Further improve medical services, optimize medical procedures, rationally arrange facilities in consultation areas, scientifically implement appointment diagnosis and treatment, and implement day surgery, telemedicine and multidisciplinary joint diagnosis and treatment models. Strengthen the emergency rescue force and smooth the green passage in front of the hospital.
The hospital informatization construction proposed in the Guiding Opinions is also closely related to the convenience of people seeking medical treatment. Zhang Wei, secretary of the Party Committee of west china hospital, analyzed that the Guiding Opinions put forward the effective docking of medical insurance, budget management, drug electronic supervision and other systems, and well designed and implemented medical services, medical quality and safety, internal audit and other systems, so as to minimize the burden of patients seeking medical treatment and the repeated work of medical staff caused by information and communication barriers and cumbersome workflow.
How to change the salary of medical staff?
— — Do not set revenue targets, and shall not be linked to the business income of the department.
Will the salary of medical staff change in the process of establishing modern hospitals? How to change? Presumably this is a problem that many people care about. According to the Guiding Opinions, public hospitals should make independent distribution within the approved total salary, reflecting post differences, taking into account the balance of disciplines, and achieving more work and more rewards.
According to the relevant regulations, hospitals can explore the implementation of target annual salary system and agreed salary. The salary of medical personnel shall not be linked to the business income of drugs, sanitary materials, inspection and testing. It is strictly forbidden to set income-generating targets for medical staff.
The Guiding Opinions also show that public hospitals should establish a public welfare-oriented assessment and evaluation mechanism, regularly organize public hospital performance assessment and dean’s annual and term target responsibility assessment, and the assessment results are linked to financial subsidies, medical insurance payment, total performance salary and dean’s salary, appointment and dismissal, rewards and punishments, etc. The assessment results will also be linked to the employment of medical staff, promotion of professional titles and personal salary.
Wang Hufeng, director of the Medical Reform Research Center of Renmin University of China, analyzed that it is an important aspect to establish a modern hospital management system to grant public hospitals autonomy in salary distribution and management under the framework of laws and regulations. "Only in this way can the enthusiasm of managers and medical staff be fully mobilized, so that medical institutions can provide quality services and efficient services." Wang Hufeng said. (End)